VAD Law in QLD From The Conversation Queensland has become the latest Australian state to move forward on the issue of voluntary assisted dying. Draft legislation, developed by the Queensland Law Reform Commission, is expected to be tabled in parliament next week. This reflects moves across the country over the past few years to permit voluntary assisted dying (also sometimes called voluntary euthanasia). The Queensland laws, if passed, would be similar to those in other states, but not identical. The Process The LNP gets a conscience vote From New Daily Queensland Opposition Leader David Crisafulli has reaffirmed his support for a conscience vote on assisted dying. The state could become the fourth to legalise euthanasia, with Premier Annastacia Palaszczuk saying the proposed laws to be introduced to parliament this week are aimed exclusively at people suffering or dying. Mr Crisafulli says he will approach the debate with an open mind and that’s “exactly what I’m asking from my team”. “It’s a serious issue and it deserves a serious response,” he told reporters on Sunday. “When I talk about a conscience vote, I mean it. I don’t mean the kind of conscience vote where people get heavied and there will be people leaning over others’ shoulders.” Mr Crisafulli also said he had no expectation that his own stance on the issue would become a signpost for his LNP colleagues. “Whatever decision I come to, I don’t want to see people following that like a conga line,” he said. “I want people to treat this with respect. I know that passion exists on both sides. I’ve seen it and I respect it.” Ms Palaszczuk, a Catholic, said last week she would allow her own MPs to vote according to their conscience after witnessing the slow and painful deaths of her grandmother and uncle. “This is a choice, and it’s not going to be the right choice for a lot of people, but it’s got to be an option for people and far be it for me to make that individual choice on how a person wishes to end their life,” she said. The Greens and independent MP Sandy Bolton support euthanasia but Katter’s Australian Party will oppose it. One Nation MP Stephen Andrew plans to study the bill before deciding. Under the bill, patients must have either a disease, illness or medical condition that is advanced, progressive and will cause death. Their condition must be expected to cause death within 12 months and cause “intolerable” suffering. Patients will have to be assessed to be acting voluntarily and without coercion, aged at least 18 and a Queensland resident. They will also need to make three applications over a period of at least nine days. Health practitioners must tell applicants they can change their mind at any point. The bill will be debated in September and, if it passes, a euthanasia system will be in place by May 2022. Institutional Conscience? From The Australian The churches operating Queensland’s biggest private hospitals and nursing homes have warned they will be forced to facilitate voluntary euthanasia for dying people under legislation to go before state parliament next week. Catholic Archbishop of Brisbane Mark Coleridge and the Uniting Church’s Queensland moderator, Andrew Gunton, said the draft bill released by Premier Annastacia Palaszczuk failed to deliver a promised right of “institutional conscientious objection”. Dr Coleridge said the legislation would allow patients who requested help to die but were too ill to be moved from a Catholic hospital to bring in outside doctors to assess them and potentially administer a death-dealing dose. “That was something that surprised and concerned me about the draft bill,” he said. “It seemed to give with one hand and take with the other — what seems to be a concession to the rights of institutional conscientious objection is in fact no real concession at all.” Reverend Gunton said if aged care home clients were classed as permanent residents they could demand that a request for VAD by carried out on site, even though the Uniting Church was adamant it would have nothing to do with euthanasia. “It seems incredibly unfair and not to what the spirit we thought this was going to be, having institutional conscientious objection,” he said. “We think it undermines the very principle which we are fighting for — our right to express our faith-based values in the facilities we run.” Catholic Health Australia provides one in five hospital and aged care beds in Queensland, listing in its portfolio Brisbane’s Mater Hospital group and Mercy Community Services, while the Uniting Church runs four major health care centres, including the Wesley Hospital, also in Brisbane, as well as 47 nursing homes statewide. While the draft legislation framed by the Queensland Law Reform Commission recognises the right of conscientious objection for medical staff and for institutions to advertise a faith-based position against VAD, Reverend Gunton said the bill otherwise was “incredibly vague”. Catholic Health Australia chief executive Pat Garcia said the existing provisions would force faith- based hospitals and homes to enable VAD on the premises. “There is no choice in that,” he said. “We have to consider the impact this supposedly voluntary scheme will have on nurses, residents and patients who choose to work, live and be treated in facilities that have expressly said they will not offer VAD. It’s a serious anomaly that must be addressed.” Deputy Premier Steven Miles said the QLRC framework allowed any institutional “entity” to opt out of VAD, but it would be required to transfer a person who qualified for assisted dying to somewhere else that allowed it. “In some situations, requiring an individual to leave their home and transfer to a different hospice, when they’re close to death and in great pain, would subject them to pain and distress or deny them access to VAD,” he said. “It’s important the VAD scheme provides all Queenslanders who are suffering and dying with equal end-of-life choices, irrespective of where they live.” Mr Miles and Attorney-General Shannon Fentiman attended a meeting with church representatives on Thursday where their concerns about being roped into VAD were put. There would be a 12-week period of further consultation after the Bill was introduced next week by Ms Palaszczuk. Queensland is the fifth state after Victoria, Western Australia, Tasmania and South Australia to enact or introduce the right to die for terminally ill people. S.9 A quick recap Victoria’s law was passed in November 2017 and came into force in June 2019 after an 18-month implementation period. Next was Western Australia, whose 2019 law will come into effect on July 1, 2021. Tasmania passed a voluntary assisted dying law in March this year, set to begin in 2022. And South Australia’s lower house is now considering its own bill, after the upper house approved the proposed law earlier this month. In New South Wales, independent MP Alex Greenwich is drafting a voluntary assisted dying law. It’s due to be released in July for consultation. The Australian Capital Territory and the Northern Territory don’t have legislative power to pass laws about voluntary assisted dying. But there are active efforts to repeal the Commonwealth law that prohibits the territories considering it. Reflecting on Victoria’s experience In preparing the draft legislation, the Queensland Law Reform Commission had the opportunity to reflect on the emerging body of evidence about how the Victorian law is operating in practice. While the safeguards in Victoria’s voluntary assisted dying system are working to ensure only eligible patients can access it, questions have been raised about challenges in accessing the law. For example, some people don’t necessarily know the option exists, while navigating the eligibility assessment process can be demanding. Background like this from Victoria’s experience led the commission to recommend some departures from laws enacted elsewhere in Australia. In Victoria, voluntary assisted dying laws have been operating for almost two years. Shutterstock The commission’s approach aimed to design “the best legal framework for a voluntary assisted dying scheme in Queensland” and not to be “constrained by similar laws in other Australian states”. In other words, the focus was on designing optimal law, rather than simply adopting another state’s law because it happened to be passed first. How is Queensland’s proposed law different? Some features are common to all Australian voluntary assisted dying laws. For example, eligibility criteria broadly include requirements that a person has an advanced and progressive condition that will cause death, and they are suffering intolerably from it. The person must also be an adult, have decision-making capacity, be acting voluntarily and satisfy various residency requirements. The Queensland proposal’s eligibility criteria are different in relation to the person’s life expectancy. A person is eligible for voluntary assisted dying under the Queensland bill if they are expected to die within 12 months. Under other Australian models, the period is six months, except for progressive neurological conditions, in which case it’s 12 months. Although some commentators (including us) question the need for a designated time period, a 12- month limit is a more coherent approach than the existing six or 12-month approach elsewhere. First, it’s very hard to justify having different time limits to access voluntary assisted dying depending on the nature of your illness. Second, a longer eligibility period allows a person who is diagnosed with a medical condition more time to apply for voluntary assisted dying. This may allow patients to start the application process a little earlier, and reduce the likelihood they may die before accessing voluntary assisted dying (given the process can take some time).